A five-year retrospective single-center analysis of 144 critically ill children found therapeutic plasma exchange showed a generally strong safety profile. Researchers reported that multiple organ dysfunction syndrome and vasopressor use were independently associated with mortality, reinforcing that disease severity—not the procedure itself—drove the worst outcomes. The work provides additional real-world evidence for clinicians using TPE in pediatric critical care, a setting where adverse event risk and uncertainty can complicate decisions. While retrospective by design, the findings support continued use in carefully selected cases and provide a reference risk profile as prospective studies build evidence for pediatric TPE indications.